Imported candy at top of contaminated food list in California

Following a state law mandating testing, the California Department of Public Health (CDPH) issued more alerts for lead in candy than for the other top three sources of food-borne contamination combined, according to the first analysis of outcomes of the 2006 law by researchers at UC San Francisco and CDPH.

For many years, the state health department’s Food and Drug Branch has routinely prepared and disseminated health alerts to regional and county public health programs, practicing community clinicians, and the general public warning of potentially toxic food exposures. However, until the 2006 law mandated a surveillance program, the CDPH did not test widely for lead in candy. The new study shows that in the six years before the law went into effect, from 2001 to 2006, only 22 percent of the alerts about food contamination involved lead in candy. Once the program was implemented, however, 42 percent of the food contamination alerts issued by state health officials were for lead in candy, nearly all of it imported, which was more than the total for SalmonellaE. coli, and botulism, according to an analysis of alerts issued between 2001 and 2014. The study was published Oct. 26, 2017, in Environmental Health Perspectives.

Lead is a toxic heavy metal that can cause developmental delays, neurological damage, hearing loss, and other serious health problems in young children and adults. The study found that active community monitoring can identify lead in food products such as candy so they can be recalled before too many people have eaten them. Without such testing, health investigators must wait until after children have been poisoned to look for the sources, which is especially difficult when the source is as perishable as candy. “With this policy change identifying lead sources is more upstream and community-based,” said Margaret Handley, Ph.D., MPH, a professor of Epidemiology and Biostatistics at UCSF and the first author of the study. “By testing candy and issuing alerts when foods are found to be contaminated, we can identify and remove sources of lead before children become poisoned.”Image result for Imported candy at top of contaminated food list in California

As many as 10,000 California children under the age of six are poisoned by lead each year, and 1,000 of them are exposed to very high levels of the toxic metal. Most efforts to reduce exposure focus on the lead found in gasoline and industrially contaminated soil, as well as lead-based paint, which children take in when they eat paint chips or breathe in dust. However, after several high-profile poisoning cases, the California legislature passed a law requiring the state health department’s Food and Drug Branch to increase surveillance of lead in candy and to issue health alerts when levels are high. Over the 14-year study period, state public health officials issued 164 health alerts for food contamination. Of these, 60 were lead-related, and 55 of those were from imported food, mostly candy from Mexico (34 percent), China (24 percent) and India (20 percent). Two alerts were issued for imported foods that were not candy: One for a toasted grasshopper snack called chapuline, the other for spices.

To get an in-depth look at how well the testing program was working, the study analyzed data for the years 2011-2012 and found that state officials had tested 1,346 candies. Of these, 65 different products were found to contain lead, and 40 of those exceeded the federal limits for children (.10 parts per million). These candies came from a more diverse set of countries compared to the overall 2001 to 2014 samples; just over a third (35 percent) came from India. The others came from Taiwan (12 percent), China (11 percent), Mexico (9 percent), Pakistan (6 percent), Hong Kong (4 percent), the United Kingdom (3 percent), and one sample each from Germany, Indonesia, Thailand, Turkey, and Spain.

Since the candy testing program is not comprehensive, the researchers said the actual number of contaminated candies and other foods on the market could be even higher. “As more lead sources are identified we must develop prevention approaches for all of them, and not just replace one prevention approach with another,” Handley said. “If there is anything we have learned from the lead poisoning disaster in Flint, Michigan, it is not to oversimplify or cut corners when it comes to identifying and removing sources of lead poisoning.”

Adapted from: University of California – San Francisco. “Imported candy at top of contaminated food list in California: More health alerts issued for lead in candy than for Salmonella, E. coli or Botulism.” ScienceDaily. ScienceDaily, 26 October 2017. <www.sciencedaily.com/releases/2017/10/171026085753.htm>

Nutritional Nugget

Prepare for the after-school rush! Prep small containers of fruits and veggies the night before so kids can help themselves when they get home.

WODal Nugget

Arita: A type of Japanese porcelain characterized by asymmetric decoration

Inspirational Nugget
Do good for others. It will come back in unexpected ways.

“At some point, we need to stop identifying with our weaknesses and shift our allegiance to our basic goodness. It’s highly beneficial to understand that our limitations are not absolute and monolithic, but relative and removable.”

~Pema ChÖdrÖn

 

World will have more obese children and adolescents than underweight by 2022

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The number of obese children and adolescents (aged 5 to 19 years) worldwide has risen tenfold in the past four decades, according to a new study led by Imperial College London and the World Health Organization (WHO). If current trends continue, more children and adolescents will be obese than moderately or severely underweight by 2022. The study is published in The Lancet. It analyzed weight and height measurements from nearly 130 million people aged over five (31.5 million people aged 5 to 19, and 97.4 million aged 20 and older), the largest number of participants ever involved in an epidemiological study. More than 1000 researchers contributed to the study, which looked at body mass index (BMI) and how obesity has changed worldwide from 1975 to 2016.

During this period, obesity rates in the world’s children and adolescents increased from less than 1% (equivalent to five million girls and six million boys) in 1975 to nearly 6% in girls (50 million) and nearly 8% in boys (74 million) in 2016. Combined, the number of obese 5 to 19-year-olds rose more than tenfold globally, from 11 million in 1975 to 124 million in 2016. An additional 213 million were overweight in 2016 but fell below the threshold for obesity. Lead author Professor Majid Ezzati, of Imperial’s School of Public Health, said: “Over the past four decades, obesity rates in children and adolescents have soared globally, and continue to do so in low-and-middle-income countries. More recently, they have plateaued in higher income countries, although obesity levels remain unacceptably high.”

Professor Ezzati adds: “These worrying trends reflect the impact of food marketing and policies across the globe, with healthy nutritious foods too expensive for poor families and communities. The trend predicts a generation of children and adolescents growing up obese and also malnourished. We need ways to make healthy, nutritious food more available at home and school, especially in poor families and communities, and regulations and taxes to protect children from unhealthy foods.”

More obese than underweight 5 to 19-year-olds by 2022

The authors say that if post-2000 trends continue, global levels of child and adolescent obesity will surpass those for moderately and severely underweight for the same age group by 2022. Nevertheless, the large number of moderately or severely underweight children and adolescents in 2016 (75 million girls and 117 boys) still represents a major public health challenge, especially in the poorest parts of the world. This reflects the threat posed by malnutrition in all its forms, with there being underweight and overweight young people living in the same communities. Children and adolescents have rapidly transitioned from mostly underweight to mostly overweight in many middle-income countries, including in East Asia, Latin America, and the Caribbean. The authors say this could reflect an increase in the consumption of energy-dense foods, especially highly processed carbohydrates, which lead to weight gain and poor lifelong health outcomes.

Dr. Fiona Bull, the programme coordinator for surveillance and population-based prevention of noncommunicable diseases (NCDs) at WHO, said: “These data highlights, remind and reinforce that overweight and obesity is a global health crisis today, and threatens to worsen in coming years unless we start taking drastic action.”

Global data for obesity and underweight

In 2016, there were 50 million obese girls and 74 million obese boys in the world, while the global number of moderately or severely underweight girls and boys was 75 million and 117 million respectively. The number of obese adults increased from 100 million in 1975 (69 million women, 31 million men) to 671 million in 2016 (390 million women, 281 million men). Another 1.3 billion adults were overweight but fell below the threshold for obesity.

Regional/Country data for obesity, BMI and underweight

Obesity:

The rise in childhood and adolescent obesity in low- and middle-income countries, especially in Asia, has accelerated since 1975. Conversely, the rise in high-income countries has slowed and plateaued. The largest increase in the number of obese children and adolescents was seen in East Asia, the high-income English-speaking region (USA, Canada, Australia, New Zealand, Ireland and the UK), and the Middle East and North Africa. In 2016, obesity rates were highest overall in Polynesia and Micronesia, at 25.4% in girls and 22.4% in boys, followed by the high-income English-speaking region. Nauru had the highest prevalence of obesity for girls (33.4%), and the Cook Islands had the highest for boys (33.3%).

In Europe, girls in Malta and boys in Greece had the highest obesity rates, at 11.3% and 16.7% of the population respectively. Girls and boys in Moldova had the lowest obesity rates, at 3.2% and 5% of the population respectively. Girls in the UK had the 73rd highest obesity rate in the world (6th in Europe), and boys in the UK had the 84th highest obesity in the world (18th in Europe). Girls in the USA had the 15th highest obesity rate in the world, and boys had the 12th highest obesity in the world. Among high-income countries, the USA had the highest obesity rates for girls and boys.

BMI:

The largest rise in BMI of children and adolescents since 1975 was in Polynesia and Micronesia for both sexes, and in central Latin America for girls. The smallest rise in the BMI of children and adolescents during the four decades covered by the study was seen in Eastern Europe. The country with the biggest rise in BMI for girls was Samoa, which rose by 5.6 kg/m2, and for boys was the Cook Islands, which rose by 4.4 kg/m2.

Underweight:

India had the highest prevalence of moderately and severely underweight (BMI <19) throughout these four decades (24.4% of girls and 39.3% of boys were moderately or severely underweight in 1975, and 22.7% and 30.7% in 2016). 97 million of the world’s moderately or severely underweight children and adolescents lived in India in 2016.

Solutions exist to reduce child and adolescent obesity

In conjunction with the release of the new obesity estimates, WHO is publishing a summary of the Ending Childhood Obesity (ECHO) Implementation Plan. The plan gives countries clear guidance on effective actions to curb childhood and adolescent obesity. WHO has also released guidelines calling on frontline healthcare workers to actively identify and manage children who are overweight or obese. Dr. Bull added: “WHO encourages countries to implement efforts to address the environments that today are increasing our children’s chance of obesity. Countries should aim particularly to reduce consumption of cheap, ultra-processed, calorie dense, nutrient poor foods. They should also reduce the time children spend on screen-based and sedentary leisure activities by promoting greater participation in physical activity through active recreation and sports.”

Dr. Sophie Hawkesworth, from the Population Health team at Wellcome Trust, which co-funded the study, said: “Global population studies on this scale are hugely important in understanding and addressing modern health challenges. This study harnessed the power of big data to highlight worrying trends of both continuing high numbers of underweight children and teenagers and a concurrent stark rise in childhood obesity. Together with global health partners and the international research community, Wellcome is working to help identify new research opportunities that could help better understand all aspects of malnutrition and the long-term health consequences.”

My thoughts: The unfortunate and sad reality is that I was not surprised when I read the research. 😔 However, this is just more proof that we have to work together as a world, not a country, to fight this epidemic…..and not only obesity but eating disorders as a whole. We can win!

Adapted from: NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128*9 million children, adolescents, and adults. The Lancet, 2017 DOI: 10.1016/ S0140-6736(17)32129-3

Nutrition Tip of the Day

Schedule time each week to plan healthy meals! Keep your recipes, grocery list, and coupons in the same place to make planning and budgeting easier.

 

Daily Inspiration 

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Calorie postings on menus cause more health mentions in online restaurant reviews

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In 2008, New York City mandated all chain restaurants to post the calories of items on their menus. The intent was to induce consumers to choose healthier items in the restaurant. A forthcoming study in the INFORMS journal Marketing Science, a leading scholarly marketing publication, investigated whether the calorie posting on menus impacted consumer evaluations of the restaurant. The study found that once the calorie posting regulation was implemented, online reviews significantly increased. The result suggests that calorie posting can not only shift consumers towards healthier alternatives when inside a restaurant, but can also, potentially, redirect consumers towards healthier restaurants and food items.

The study, “The Effect of Calorie Posting Regulation on Consumer Opinion: A Flexible Latent Dirichlet Allocation Model with Informative Priors,” was co-authored by Dinesh Puranam of the University of Southern California, Vishal Narayan of the National University of Singapore, and Vrinda Kadiyali of Cornell University. The authors analyzed 761,962 restaurant reviews across 9,805 restaurants on an online restaurant review website in New York City from 2004 to 2012. Using text-mining methods, the authors examined the change in the mentions of health in reviews over time before and after the calorie posting rule went into effect. To rule out the possibility that the health mentions increase was simply due to increased public interest in health issues over time, they compared the change in topics discussed for chain restaurants, relative to non-chain restaurants which were not mandated by the rule to post calorie information. The authors found a significant increase in the proportion of reviews that discussed health for chain restaurants, relative to non-chain restaurants.

The authors also explored in greater detail the source of the increase in health topics. They found that it was largely driven by new reviewers who were previously not active in posting reviews, but began to post more reviews after the mandate. Puranam noted that “Interestingly, the increase in health discussion in opinions was not confined to restaurants in more affluent localities, commonly associated with more health-conscious consumers. This is an encouraging sign of the success of the rule across the socioeconomic divide — especially given the greater incidence of obesity among lower socioeconomic classes.”

New York City recently expanded the rule beyond chain restaurants to also include fine dining restaurants. Narayan noted that “our result that calorie posting on menus impacts online reviews is significant for this rule expansion since consumers are even more likely to consult reviews for fine dining restaurants than for chain restaurants that they habitually visit. Whether this will have an impact on the caloric content of items on fine dining restaurant menus of restaurants, of course, remains to be seen.”

Kadiyali cautioned that more work is needed to study whether the increased discussion of health topics actually do lead to a greater choice of healthier restaurants. “It is possible that the health-conscious consumers may choose healthier restaurants while the less health conscious may avoid them. In this case, health benefits across the population may be ambiguous. Nevertheless, our study suggests that online reviews are a useful place to look for potential changes in consumer behavior due to this rule,” she said.

Adapted from: Dinesh Puranam, Vishal Narayan, Vrinda Kadiyali. The Effect of Calorie Posting Regulation on Consumer Opinion: A Flexible Latent Dirichlet Allocation Model with Informative Priors. Marketing Science, 2017; DOI: 10.1287/mksc.2017.1048

Nutrition Tip of the Day

Instead of frying foods which can add a lot of extra calories and unhealthy fats, use healthier cooking methods that add little or no solid fat, like roasting, grilling, baking or steaming.

Daily Inspiration 

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